Newly diagnosed diabetes has high risk for cardiovascular outcome in ischemic stroke patients

Area of Science:

• Cardiology
• Endocrinology
• Neurology

Background:

• The cardiovascular risk associated with newly diagnosed diabetes mellitus (DM) following ischemic stroke is not well-established.
• Glycosylated hemoglobin (HbA1c) criteria can identify new-onset DM.
• Understanding this risk is crucial for patient management and secondary prevention strategies.

Purpose of the Study:

• To compare cardiovascular outcomes in ischemic stroke patients with newly diagnosed DM versus those with previously known DM and no DM.
• To determine if new-onset DM is an independent risk factor for adverse cardiovascular events post-stroke.

Main Methods:

• Post hoc analysis of data from the Prevention of Cardiovascular events in iSchemic Stroke patients with high risk of cerebral hemOrrhage (PICASSO) trial.
• Newly diagnosed DM defined as HbA1c ≥ 6.5% in patients without a prior DM diagnosis.
• Composite cardiovascular events (stroke, myocardial infarction, cardiovascular death) were tracked.

Main Results:

• Among 1306 patients, 2.9% had newly diagnosed DM, 33.5% had known DM, and 63.6% had no DM.
• The incidence of ischemic stroke was highest in the newly diagnosed DM group (8.93 per 100 person-years).
• Composite cardiovascular event incidence was also significantly higher in patients with newly diagnosed DM (8.93 per 100 person-years) compared to known DM (5.92) and no DM (3.87).

Conclusions:

• Newly diagnosed diabetes mellitus is a significant risk factor for ischemic stroke and overall cardiovascular events in patients who have experienced a stroke.
• Early identification and intervention for new-onset DM after ischemic stroke are critical for improving cardiovascular outcomes.
• The study underscores the need for rigorous glycemic control and cardiovascular risk management in this patient population.